Tips for Managing Extremely Severe Anxiety

If you find yourself facing a crisis, cycle through these steps:

What To Do In A Crisis

A crisis can present in many different forms, from the death of a loved one, to loss of a job, to collapse of a
marriage, to financial disaster. When you are hit by a crisis, an emotional storm is likely to whip through your
mind and body, tossing painful thoughts and feelings in all directions. Here’s what you can do to survive and
thrive: S.T.O.P.

Slow your breathing
• Take a few deep breaths, and mindfully observe the breath flowing in and flowing out. This will help to
anchor you in the present.

Take note
• Take note of your experience in this moment. Notice what you are thinking. Notice what you are feeling.
Notice what you are doing. Notice how your thoughts and feelings are swirling around, and can easily
carry you away if you allow them.

Open up
• Open up around your feelings. Breathe into them and make room for them. Open up to your thoughts too:
take a step back and give them some room to move, without holding onto them or trying to push them
away. See them for what they are and give them space, rather than fusing with them.

Pursue your values
• Once you’ve done the above three steps, you will be in a mental state of mindfulness. The next step is to
respond to the crisis by pursuing a valued course of action. Connect with your values: ask yourself,
‘What do I want to be about, in the face of this crisis? What do I want to stand for? How would I like to
act, so that I can look back years from now and feel proud of my response?’

Things to Consider
1) Do you need, or would you benefit from help/assistance/support/advice? If so, what friends, neighbors,
or relatives can you contact? What professionals could you arrange to see? (If necessary, what helpline
numbers could you call?)
2) Have you experienced anything similar before? If so, how did you respond that was useful and helpful in
the long term? Is there anything you learned from that experience that you can usefully apply now?
3) Is there anything you can do to improve the situation in any way? Are there any TINY steps you could
take immediately that could be helpful? What are the smallest, simplest, easiest, tiny steps you could
a) in the next few minutes
b) in the next few hours
c) in the next few days
Note: the first step might simply be to spend a few minutes practicing some mindful breathing – or to
take out a pen and paper and write an action plan.

4) If there is nothing you can do to improve the situation, then are you willing to practice acceptance, using
expansion and defusion skills, while engaging fully in the present moment? And given that the situation
is unchangeable, how can you spend your time and energy constructively, rather than worrying or
blaming or dwelling? Again, reconnect with your values: what do you want to be about in response to
this situation? What are some tiny values-driven steps you can take?
5) You don’t get to choose the deck of cards you are dealt in life; you only get to choose how you play with
them. So a useful question to ask is: ‘Given this is the hand I’ve been dealt, what’s the best way to play
with it? What personal strengths can I develop or strengthen as I go through this ordeal? How can I learn
and grow from this experience?’ Note: any painful experience is an opportunity to develop your
mindfulness skills.

6) Be compassionate to yourself. Ask yourself, ‘If someone I loved was going through this experience,
feeling what I am feeling – if I wanted to be kind and caring towards them, how would I treat them? How
would I behave towards them? What might I say or do?’ Then try treating yourself the same way.

© Russ Harris 2008

Find some simple facts about Anxiety:

What contributes to anxiety?

There are a number of factors that contribute to anxiety:
• Genetics — it is believed there is a genetic component to anxiety. Individuals may be more vulnerable to develop anxiety if it runs in the family.
• Thinking style — people with anxiety have negative or unhelpful thoughts and beliefs that may perpetuate their condition.
• Personality type — certain people are more sensitive and cautious or fearful in nature making them more likely to develop anxiety.
• Stress or trauma — following a stressful or traumatic event, a person may develop anxiety as a response to the event.
• Physical health — people in poor physical health will not be as resilient to dealing with life stressors and may be more likely to develop anxiety.
• Substance use — certain substances, including cannabis and cocaine and even caffeine in high doses, can illicit the physical symptoms associated with anxiety, such as increased heart rate.
• Other mental health conditions — an anxiety disorder can be diagnosed in addition to another mental health condition, such as depression. It may be diagnosed as a feature of a mental illness, for example a psychotic disorder.
• Avoidance behaviours — certain behaviours perpetuate anxiety and prevent people from finding healthy ways to cope with their fears
and anxiety. Avoidance as a coping strategy serves to reinforce the unhealthy thinking that contributes to the anxiety disorder.

Symptoms of anxiety

Listed below are some of the common physical signs and symptoms associated with anxiety:
• Restlessness
• Feeling on edge
• Rapid heartbeat
• Shortness of breath
• Difficulty concentrating
• Feeling lightheaded or faint
• Irritability
• Muscle tension
• Upset stomach
• Sweating
• Sleep disturbance

Anxiety disorders:

• Separation anxiety disorder — extreme fear or anxiety about separation from attachment figures that is not developmentally appropriate.
• Specific phobias — extreme fear or anxiety about a specific object or situation and subsequent avoidance of that object or situation. The fear or anxiety is disproportionate to the actual risk posed by the object or situation. Ready to help 24/7. 13 11 14
• Social anxiety disorder (social phobia) — extreme fear or anxiety about social interactions and situations where the person believes they will be negatively evaluated by others. A person with social anxiety will avoid social interactions or situations where they believe they will be embarrassed, humiliated or rejected.
• Panic disorder — this condition is diagnosed when a person experiences recurrent unexpected panic attacks and is persistently concerned about having another panic attack. A panic attack is an abrupt surge of intense fear with accompanying physical symptoms and thoughts.
• Agoraphobia — extreme fear or anxiety about certain situations and the possibility of having a panic attack. Situations may include using
public transport, being in open spaces, being in enclosed spaces, standing in line or being in a crowd, or being outside of the home alone. The cause of the fear or anxiety is subsequently avoided.
• Generalised anxiety disorder — persistent and excessive anxiety about a range of life domains including school, work, health or family. The person finds these difficult to control and experiences associated physical symptoms. People may also experience anxiety in relation
to substance use or withdrawal and other mental health conditions.

How to manage anxiety

Anxiety is a manageable condition. It is important to seek help to manage your anxiety if it is preventing you from functioning in a normal
way. If you know someone who is affected by anxiety encourage them to seek help and reassure them that there are treatment options available.
Below are some strategies you may find helpful if you are experiencing anxiety:
• Identify how you are feeling and acknowledge your emotional response in relation to the situation. Accept your experience and talk
to someone about how you are feeling.
• Focus on your breath – An example of a breathing technique is provided below:
Breathe in slowly, counting silently to yourself:
1…2…3…4…5…Hold your breath for a moment.
Breathe out slowly, counting silently to yourself:
Continue to breathe in this way for a few minutes to assist your heart rate to reduce.

• Practice meditation. There are guided meditations available online and apps you can download for free. Some examples include:
– headspace Meditation App:
– Smiling Mind Meditation for Young People:

• Engage in a treatment for anxiety. Cognitive Behavioural Therapy (CBT) is an effective evidence-based treatment for anxiety disorders. CBT addresses the thoughts that contribute to anxiety and assists with behavioural change including reducing the tendency to avoid things that provoke anxiety.

Video: The Stress Response – Fight or Flight

Audio: Dropping Anchor (11 minutes)

Dropping an anchor is an exercise that is designed to enable your body and mind to become grounded, reduce your state of hyperarousal and engage your parasympathetic nervous system and calm down your body.